‘‘(hhh)(1) Subject to paragraphs (3) and (4), the
7 term ‘advance care planning consultation’ means a consultation between the individual and a practitioner de9
scribed in paragraph (2) regarding advance care planning,
10 if, subject to paragraph (3), the individual involved has
11 not had such a consultation within the last 5 years.
I believe that there may be some confusion here.
The Advanced Care Directive is not an attempt to get people to kill themselves. My wife and I each have one. So should you, and they should be updated regularly to conform to your wishes.
What they are is a written document about what you wish to happen if you are not available to make health care decisions for yourself. They will be used by the health care providers as a guide to what they will do in case you become unable to communicate your wishes directly; should you, say, lapse into a coma. In my case, I have said that I want my wife to make the health care decisions for me, if I'm not available to do so.
In this document I am allowed to stipulate whether I wish heroic measures to be taken to keep me alive — repeated resuscitation, being maintained on a ventilator, being maintained if I show not vegetative signs of life, being maintained if I cannot breath for myself, being maintained if I show not higher cortical function and so on. I can specify these things, and let my own personal wishes be known. The medical folks will then carry out these wishes, or the wishes of my nominated health care proxy — in my case, my wife.
These documents should be reviewed every five years because some of your thinking may have changed in that time — perhaps you now want your cousin to be your proxy rather than your father. Perhaps your father has died and you no longer have him available to make those proxy decisions for you. Perhaps you would now wish to be kept alive as long as the professionals can manage it rather than wanting them to pull the plug if you're brain dead. These things can change over time, and the documents should reflect your current thinking.
In terms of the government wishing this to be the case, it means that there is less overall dissatisfaction with the system, and that folks are more likely to be getting the care they want to be getting at the moment.
I've just had to go through this with the death of my own father in December and the death of my father in law last month. Both of them were fortunate to have had directives to make their wishes known and to make sure they were followed, since neither of them were conscious at the end.
If you do not have a health care directive on file with your hospital and you physician, you really ought to consider one. At the very least, you could consider researching the subject and decide on the pro and con elements yourselves.
Don't let the difficulty over partisan quarrel over health care get in the way of your finding out about something that will give you more control over your health care and your treatment instead of less, and which would have headed off much of the terrible problems with the Terry Schiavo case a few years back. If she had left her wishes in writing on file with her health care providers, much of the divisive struggle might well have been availed. We would actively know whether she wished to be still on life support today, or whether she had been kept alive for years against her expressed wishes as a political football.
Sincerely, Bob Kaven